Randomized feasibility study of twice a day functional electrostimulation in patients with severe chronic obstructive pulmonary disease hospitalized for acute exacerbation

López‐López, Laura; Torres‐Sánchez, Irene; Rodríguez‐Torres, Janet; Cabrera‐Martos, Irene; Cahalin, Lawrence P.; Valenza, Marie Carmen

doi:10.1080/09593985.2019.1694611

Cited by 9 publications

(47 citation statements)

References 47 publications

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“…The most used components in the interventions were aerobic training, strength training, breathing techniques and education and psychosocial support, either in isolation [19,25,27,30,32,41,45,47,48,52,54,55,58,59] or in combination [18, 20-24, 26, 28, 29, 31, 33-40, 42-44, 46, 49-51, 53, 56, 57], both of which are also common in pulmonary rehabilitation practice with patients with stable COPD [60]. Nevertheless, during AECOPD, patients present an increased airway and systemic inflammation that results in increased dyspnoea, cough and sputum volume and purulence, and further impairment of muscle strength, functionality and exercise tolerance and, hence, different characteristics and needs from those in the stable phase [1,61,62].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, patient's knowledge was one of the outcome measures presenting larger ES, showing how empowering pulmonary rehabilitation can be during AECOPD. It has been recognised that many AECOPD occur without being Exercise and breathing techniques [48] [ 24,29,33,36,45,46,51] [ 31,42,51,53] reported to health professionals [1]. Despite the short duration of these events, they have a negative impact on patients' health status, thus highlighting the importance of educating these patients [1].…”

Section: Discussionmentioning

confidence: 99%

“…Most frequent timings to begin intervention were 24-48 h after hospital admission (n=10) [22,30,31,40,41,45,46,49,53,57], after hospital discharge (n=5) [28,33,35,38,56], at the moment of hospital discharge (n=4) [18,19,36,47] and at hospital admission (n=3) [25,43,55]. [27,45,46,53], positive expiratory pressure therapy performed with noninvasive ventilation [22,54] or devices (n=3) [49], home diaries (n=2) [35,36], respiratory muscle training (n=1) [37], nutrition (n=1) [28] and whole body vibration (n=1) [30]. Only 16 (38.1%) of the included studies [18, 21-24, 26, 28, 29, 31, 34, 35, 38, 39, 44, 46, 56] used pulmonary rehabilitation as an intervention if the pulmonary rehabilitation definition is taken into account [4].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Aerobic training was prescribed at 40-85% of the maximal or submaximal test result [24, 31-33, 37, 40, 44] and strength training at 40-80% of 1-repetition maximum [24,26,40,43,44]. Additional components used were: electrostimulation, which was applied using a range of frequencies from 12-50 Hz [27,30,45,53], with 50 Hz being the most used frequency; positive expiratory pressure therapy which was performed using 10-20 cmH 2 O [22,49]; and respiratory muscle training which was set at 50% of maximal inspiratory pressure [37].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

et al. 2020

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This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care. 42 studies were included. Most studies were conducted in an inpatient setting (57%) and started the intervention 24–48 h after hospital admission (24%). Exercise training (71%), education and psychosocial support (57%) and breathing techniques (55%) were the most used components. Studies combining exercise with breathing techniques presented the larger effects on exercise capacity (weighted mean difference (WMD) −41.06, 95% CI −131.70–49.58) and health-related quality of life (WMD 16.07, 95% CI 10.29–21.84), and breathing techniques presented the larger effects on dyspnoea (WMD 1.90, 95% CI 0.53–3.27) and length of hospitalisation (effect size =0.15, 95% CI −0.28–0.57). A few minor adverse events were found.Pulmonary rehabilitation is a safe intervention during AECOPD. Exercise, breathing techniques, and education and psychosocial support seem to be the core components for implementing pulmonary rehabilitation during AECOPD. Studies may now focus on comparisons of optimal timings to start the intervention, total duration of the intervention, duration and frequency of sessions, and intensity for exercise prescription.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

et al. 2020

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“…On the other hand, there is solid evidence of the clinical efficacy of exercise rehabilitation during hospitalization in AECOPD patients [28,[38][39][40]. Troosters et al [41] concluded that resistance global training is an efficacy and safe strategy to decrease the loss of musculoskeletal function during AECOPD.…”

Section: Discussionmentioning

confidence: 99%

A Feasibility and Efficacy Randomized Controlled Trial of Two Exercise Programs in Severe AECOPD Patients with Resting Hypoxemia

et al. 2021

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Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was to assess the feasibility and the efficacy of two exercise programs in Acute Exacerbation of COPD (AECOPD) patients with resting hypoxemia. In this randomized clinical trial, patients hospitalized due to an acute exacerbation of COPD with hypoxemia at rest were included. Patients were randomly assigned into three groups. A Control Group (pharmacological treatment), a Global Exercise Group (GEG), and a Functional Electrostimulation Group (FEG). Patients were treated during the hospitalization period. The main outcomes were lower limb strength (assessed by a dynamometer), balance (assessed by the one leg standing balance test), health related quality of life (assessed by the EQ-5D), adverse events and adherence. At the end of the intervention, there were significant differences in all the variables in favour of the experimental groups (p < 0.05). We concluded that conducting an exercise program is feasible and improves lower limb strength, balance, and health related quality of life in AECOPD patients with resting hypoxemia.

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Effectiveness of neuromuscular electrical stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta‐analysis

Okura,

Nonoyama,

Shibuya

et al. 2024

Physiotherapy Res Intl

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Background and PurposeThis study aimed to investigate the effectiveness and acceptability of neuromuscular electrical stimulation (NMES) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).MethodsWe conducted a systematic review and meta‐analysis to investigate the effectiveness and accessibility of NMES and compared them with usual care in patients with acute exacerbation of COPD by searching databases such as MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials published up to April 2022. Randomized controlled trials (RCTs) involving patients with COPD who were treated within 3 weeks of acute exacerbation onset were included. The risk of bias was assessed using the RoB 2 tools. We pooled limb muscle strength and adverse events and performed a comparison between NMES and usual care. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach.ResultsFive RCTs, including 168 patients, met the eligibility criteria. The meta‐analysis showed that limb muscle strength was significantly higher in the NMES group (four studies with 148 patients; standardized mean difference, 0.95; 95% confidence interval, 0.60–1.30; p < 0.001). The quality of evidence was very low due to the risk of bias within the studies, imprecision of the estimates, and small number of studies. Any adverse events served as outcomes in three studies (86 patients), although no adverse events occurred.ConclusionNMES is safe for patients with acute exacerbation of COPD and may maintain and improve limb muscle strength; however, the quality of evidence was very low.

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Randomized feasibility study of twice a day functional electrostimulation in patients with severe chronic obstructive pulmonary disease hospitalized for acute exacerbation

Cited by 9 publications

References 47 publications

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

A Feasibility and Efficacy Randomized Controlled Trial of Two Exercise Programs in Severe AECOPD Patients with Resting Hypoxemia

Effectiveness of neuromuscular electrical stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta‐analysis

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